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Perioperative Syndecan-1 Dynamics During Cardiac Surgery: Associations with Operative Factors and Patient
Tadas Cesnaitis1, Tadas Lenkutis2, Renata Paukstaitiene3
1Heart Centre, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
Medicina (Kaunas, Lithuania)
|July 28, 2026
Summary
Cardiac surgery with cardiopulmonary bypass increases Syndecan-1 levels, a biomarker for endothelial glycocalyx shedding. Aortic cross-clamp duration and male sex were linked to higher concentrations, suggesting ischemia-reperfusion injury plays a role.
Area of Science:
- Cardiovascular Surgery
- Biomarkers
- Endothelial Function
Background:
- Cardiac surgery using cardiopulmonary bypass (CPB) can cause endothelial glycocalyx injury and dysfunction.
- Syndecan-1 is a key biomarker for glycocalyx shedding, but its perioperative changes and influencing factors require further investigation.
Purpose of the Study:
- To investigate perioperative Syndecan-1 dynamics during coronary artery bypass grafting (CABG) with CPB.
- To explore associations between Syndecan-1 changes, ischemia-reperfusion exposure, and patient characteristics.
Main Methods:
- Prospective observational study of 147 patients undergoing elective CABG with CPB.
- Syndecan-1 levels measured at five perioperative time points.
- Analysis included non-parametric tests, Spearman correlation, and mixed-effects modeling.
Main Results:
- Syndecan-1 concentrations significantly increased over time, peaking at ICU admission (147.78 ng/mL) from baseline (49.74 ng/mL).
- Aortic cross-clamp duration showed a weak but significant association with higher Syndecan-1 levels.
- Male sex and aortic cross-clamp duration were independently associated with increased Syndecan-1, while CPB duration was not.
Conclusions:
- Syndecan-1 levels rise significantly during CABG with CPB, peaking upon ICU admission.
- Aortic cross-clamping duration is linked to glycocalyx shedding, supporting the role of ischemia-reperfusion injury.
- Male sex is an independent factor associated with elevated Syndecan-1 levels post-surgery.
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